American Chemical Society Chemistry and the Premedical Curriculum: The Impact of MCAT 2015 Chemical Sciences Roundtable May 22, 2013 Joel Shulman University of Cincinnati
AAMC-HHMI Report on Scientific Foundations for Future Physicians (2009) Advocates a focus on competencies rather than on specific courses taken or disciplines studied Targets both premedical and medical education American Chemical Society 2
A Goal of the AAMC: Transforming Admissions i to Medical School Transforming admissions to keep pace with changes in science and medical education Preparing a physician workforce to improve the health of all
What is competency? A combination of skills, abilities, and knowledge a needed to perform a specific task What is scientific competency in medical practice? Knowledge, skills and habits of mind needed to understand scientific concepts and discoveries, to integrate them into medical practice, and to communicate them effectively to patients
Implications for Medical School Admission i SFFP (and thus, AAMC) recommends that medical schools reassess their current prerequisite course requirements with a focus on creating the least- restrictive ti pathway for applicants. Decouple specific prerequisites from desired outcomes of premedical education Competency-Based Admissions: ability to demonstrate a core set of entry-level competencies needed to succeed din medical school, in residency, and din practice Assess newly defined scientific competencies credibly and reliably by the MCAT
Blue-ribbon Panel Reports Scientific Foundations for Future Physicians Report (2009) Behavioral and Social Science Foundations for Future Physicians (2011) Roadmap to Diversity: Integrating g Holistic Review Practices (2010)
MCAT 2015 4 Sections, 4 Scores Biological & Biochemical Foundations of Living Systems Chemical & Physical Foundations of Biological i l Systems Psychological, Social, & Biological Foundations of Behavior Critical Analysis & Reasoning Skills 7
Critical Analysis & Reasoning Skills Asks examinees to critically analyze, evaluate, and apply information presented in passages from humanities and social sciences, including: Ethics Philosophy Population health Cross-cultural studies Specific disciplinary knowledge not needed 8
Competencies for Entering Medical Students Competency E1 Apply quantitative reasoning and appropriate mathematics to describe or explain phenomena in the natural world. Competency E3 Demonstrate knowledge of basic physical principles and their applications to the understanding of living systems. Competency E2 Demonstrate understanding of the process of scientific inquiry, and explain how scientific knowledge is discovered and validated. Competency E4 Demonstrate knowledge of basic principles of chemistry and some of their applications to the understanding of living systems. Competency E5 Demonstrate knowledge of how biomolecules contribute to the structure and function of cells. Competency E7 Explain how organisms sense and control their internal environment and how they respond to external change. Competency E6 Apply understanding of principles of how molecular and cell assemblies, organs and organisms develop structure and carry out function. Competency E8 Demonstrate an understanding of how the organizing principle of evolution by natural selection explains the diversity of life on earth. American Chemical Society 9
Competency E4: Examples of Learning Objectives Demonstrate knowledge of basic principles of chemistry and some of their applications to the understanding of living systems. Demonstrate knowledge of atomic structure. Demonstrate knowledge of molecular structure. Demonstrate knowledge of (inter)molecular interactions. Demonstrate knowledge of thermodynamic criteria for spontaneity of physical processes and chemical reactions. Demonstrate knowledge of the chemistry of carbon-containing compounds relevant to their behavior in an aqueous environment. American Chemical Society 10
Combining Skills and Concepts Skill 1 Skill 2 Skill 3 Skill 4 Foundational Concept 1 Foundational Concept 2 Content Content Content Content Content Content Category Category Category Category Category Category 1A 1B 1C 2A 2B 2C Each cell represents the point at which foundational concepts, content categories, and scientific inquiry and reasoning skills cross Test questions are written at the intersections of the content and skills 11
Chemical & Physical Foundations of Biological Systems Foundational Concept 5 The principles that govern chemical interactions and reactions form the basis for a broader understanding of the molecular dynamics of living systems. 12
MCAT 2015 The Biological and Biochemical Foundations of Living Systems and the Chemical and Physical Foundations of Biological Systems sections are designed to: test introductory-level biology, organic and inorganic chemistry, and physics concepts; test biochemistry concepts at the level taught in many colleges and universities in first-semester biochemistry courses; test cellular/molecular biology topics at the level taught in many colleges and universities in introductory biology sequences; target basic research methods and statistics concepts described by many baccalaureate faculty as important to success in introductory science courses; and require students to demonstrate their scientific inquiry and reasoning, research methods, and statistics skills as applied to the natural sciences. American Chemical Society 13 https://www.aamc.org/students/download/266006/data/2015previewguide.pdf
Chemical & Physical Foundations of Biological Systems Approximate Distribution of Questions General chemistry: 30% Organic chemistry: 25% First-semester biochemistry: 15% Introductory yphysics: 25% Introductory biology: 5% American Chemical Society 14
Competencies may be best developed within an interdisciplinary context Apply concepts of chemistry to biological examples in biology courses? Explore basic chemistry principles within biological i l contexts t in chemistry courses? Or both? American Chemical Society 15
Should the Chemistry Curriculum Change in Response to MCAT 2015? Currently, most pre-medical students complete five semesters of chemistry: one year of general chemistry one year of organic chemistry one semester of biochemistry It is not obvious that any change is required. However, SFFP presents both opportunities and challenges for the chemistry community. American Chemical Society 16
Opportunities Catalyzed by SFFP Recognize that most freshman and sophomore chemistry students not only premeds have a strong biological interest. Introduce more biological examples into both general and organic chemistry. Take advantage of the flexibility in the 2008 ACS Guidelines for Undergraduate Professional Education in Chemistry to reorganize chemistry programs. Guidelines require at a minimum the equivalent of a onesemester course in each of the five major areas of chemistry. Guidelines do not require two semesters of any given area of chemistry, including organic. American Chemical Society 17
Examples of Curricular Modifications to Meet the Interests of Premeds and Others Traditional curriculum: One year each of general chemistry and organic chemistry Second semester of organic offered as a choice between Bioorganic or Mechanism & Synthesis 1-2-1 1 approach Organic first Fully integrated t foundation courses All of these approaches assume a separate one- or two-semester biochemistry course. American Chemical Society 18
Traditional Approach: One Year Each of fgeneral and dorganic Chemistry Integrate biological examples whenever possible. Enzyme catalysis, including the role of proximity within the active sites and the influence of nonbonding interactions Peptide bonds and protein conformations when discussing carboxylic acid derivatives Monosaccharide structure and mutorotation when discussing hemiacetal and acetal formation Converting OH to phosphate or sulfate ester leaving groups Biologically i ll relevant reactions in addition to standard d synthetic reactions NADH as a reducing agent Claisen condensation of acetyl CoA to form acetoacetyl CoA American Chemical Society 19
Second-Semester Semester Organic: Bioorganic or Mechanism & Synthesis First semester of organic: Introduce most of the major concepts, including functional groups and some spectroscopy Second semester, offer a choice of two courses Bioorganic, for premeds and other biology-oriented students Mechanism and Synthesis, with emphasis on retrosynthesis and physical organic, for majors, chemical engineers, etc. Obviously depends on available teaching resources to present two different second-semester courses American Chemical Society 20
1-2-1 Approach A two-year curriculum consisting of a semester of general chemistry, two semesters of organic, then one of biochemistry HHMI grant to Purdue to develop a 1-2-1 approach based closely on the SFFP competencies General chemistry can have a strong acid-base approach with connections to biochemistry Organic emphasizes reactions and mechanisms with biochemical analogies, de-emphasizes retrosynthesis and organometallics Assumes freshman are adequately prepared so that one semester of general chemistry is sufficient for success in organic American Chemical Society 21
Organic First Freshmen start with biologically flavored organic Not a traditional organic course Rather, introduces some general-chemistry concepts intercalated with relevant biologically related material This can be followed by Two semesters of mainstream chemistry (e.g., inorganic and analytical); or One mainstream chemistry course and a biochemistry course American Chemical Society 22
An Example of Fully Integrated Foundation Courses* Replace the standard first two years of chemistry Structure and Properties (one semester) Reactivity I, II, and III (three semesters) Integrate structure and reactivity in the context of organic, inorganic, and biochemistry Link topics so that t students t can see their relevance to society Coordinate with the SFFP and MCAT 2015 competencies Demonstrate to ACS Committee on Professional Training that these courses meet the Guidelines for approval * College of St. Benedict-St. John s University American Chemical Society 23
Some Challenges Presented by SFFP Ability of smaller schools to accommodate the chemistry requirement of all majors Curricular change takes Buy-in from full faculty and coordination among departments Availability of appropriate texts Articulation between two- and four-year colleges with modified curriculum Availability of resources to teach modified courses Possible reduction of TA needs/support American Chemical Society 24
Some Unanswered Questions Raised in Response to SFFP Will medical schools have the ability and desire to adjust admission criteria to reflect competencies? Will undergraduate programs be motivated to map courses to premedical competencies? Will MCAT 2015 be successful in assessing competencies credibly and reliably? Will MCAT 2015 minimize emphasis on non-biologically relevant chemistry? Two examples of content that may be tested*: Grignard reagents Preparation of mesylates and tosylates * Preview Guide for the MCAT 2015 Exam American Chemical Society 25
Another Interesting Challenge Recommends one year of chemistry (general + organic) and one year of biochemistry i for pre-med students. As an intermediate step, recommends a 1:2:1 sequence (Purdue model) American Chemical Society 26
The Bottom Line We need to see how MCAT 2015 is constructed and how it treats the intersection of content and skills in chemistry. Regardless of MCAT 2015, we should recognize that for most chemistry programs the majority of first- and second-year students t have a strong biological i l interest. t Is your program optimally constructed to take this into consideration? Metrics will be needed to determine if any pedagogical changes are meeting the needs of all students. American Chemical Society 27
Thank you! American Chemical Society 28